University of Oulu

Koskela, L, Raatiniemi, L, Ehrola, A, Kaakinen, T, Lahtinen, S, Liisanantti, J. Accuracy of dispatch and prehospital triage performance in poisonings – A retrospective study from northern Finland. Acta Anaesthesiol Scand. 2023; 67( 1): 112- 119. doi:10.1111/aas.14152

Accuracy of dispatch and prehospital triage performance in poisonings : a retrospective study from northern Finland

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Author: Koskela, Lauri1; Raatiniemi, Lasse2; Ehrola, Ari3;
Organizations: 1Research Group of Surgery, Anesthesiology and Intensive Care Medicine, Medical Research Center Oulu, Oulu, Finland
2Centre for prehospital emergency care, Oulu University Hospital, Oulu, Finland
3Emergency Medical Services, Northern Ostrobothnian Hospital District, Oulu, Finland
4Department of Anesthesiology, Oulu University Hospital, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe202301193726
Language: English
Published: John Wiley & Sons, 2022
Publish Date: 2023-01-19
Description:

Abstract

Background: Increasing numbers of dispatches place a burden on EMS; this study sought to assess the prehospital evaluation of poisoned patients transported to hospital. The primary aim of this study was to measure dispatch centre and EMS provider performance as well as factors contributing to the recognition of poisoning among prehospital patients. The secondary aim was to compare triage performance between dispatch centres and EMS providers.

Methods: A retrospective single-centre study in Northern Finland was conducted. Patients suspected as poisonings by dispatch centres as well as other EMS-transported patients who received a diagnosis of poisoning in hospital between June 1, 2015 and June 1, 2017, were included.

Results: There were a total of 1668 poisoning-related EMS missions. Dispatch centres suspected poisonings with sensitivity of 79.9% (95% CI 76.7–82.9) and specificity of 98.9% (95% CI 98.9–99.0) when all EMS missions were taken into account. In a logistic regression model, decreased state of consciousness as dispatch code (OR 7.18, 95% CI 1.90–27.05) and intravenous fluid resuscitation (OR 6.58, 95% CI 1.34–32.37) were associated with EMS transport providers not recognizing poisoning. Overtriage rate appeared significantly higher (33.6%, 95% CI 28.6–39.2) for dispatch when compared with transport (17.8%, 95% CI 13.9–22.6).

Conclusion: Dispatch centres seem to suspect poisonings fairly accurately. Poisonings unrecognized by EMS providers may be linked with intravenous fluid resuscitation and decreased patient consciousness. Overtriage appears to resolve somewhat from dispatch to transport. There were no fatal poisonings in this study population.

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Series: Acta anaesthesiologica Scandinavica
ISSN: 0001-5172
ISSN-E: 1399-6576
ISSN-L: 0001-5172
Volume: 67
Pages: 112 - 119
DOI: 10.1111/aas.14152
OADOI: https://oadoi.org/10.1111/aas.14152
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Subjects:
Funding: Suomen alkoholitutkimussäätiö (Finnish foundation for alcohol studies), Grant/Award Number: Grant; Suomen Lääketieteen Säätiö, Grant/Award Number: Eka 2017.
Copyright information: © 2022 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
  https://creativecommons.org/licenses/by/4.0/